Prevalence and Risk Factors of Blindness Among Primary Angle Closure Glaucoma Patients in the United States: An IRIS Registry Analysis.
Shah Sona N, Zhou Sarah, Sanvicente Carina, Burkemper Bruce, Apolo Galo, Li Charles, Li Siying, Liu Lynn, Lum Flora, Moghimi Sasan
AI Summary
This study found 1 in 9 newly diagnosed US PACG patients are blind. Black/Hispanic race and public insurance increase blindness risk, highlighting disparities and need for earlier detection.
Abstract
Purpose
To assess the prevalence and risk factors of blindness among patients newly diagnosed with primary angle closure glaucoma (PACG) in the United States.
Design
Retrospective cross-sectional study.
Methods
Eligible patients from the American Academy of Ophthalmology (AAO) Intelligent Research in Sight (IRIS) Registry had newly diagnosed PACG, defined as: 1) observable during a 24-month lookback period from index date of PACG diagnosis; 2) no history of eye drops, laser, or cataract surgery unless preceded by a diagnosis of anatomical narrow angle (ANA); and 3) no history of glaucoma surgery. Logistic regression models were developed to identify risk factors for any (one or both eyes) or bilateral (both eyes) blindness (visual acuity ≤20/200) at first diagnosis of PACG.
Results
Among 43,901 eligible patients, overall prevalence of any and bilateral blindness were 11.5% and 1.8%, respectively. Black and Hispanic patients were at higher risk of any (odds ratios [ORs] 1.42 and 1.21, respectively; P < .001) and bilateral (ORs 2.04 and 1.53, respectively; P < .001) blindness compared with non-Hispanic White patients adjusted for ocular comorbidities. Age <50 or >80 years, male sex, Medicaid or Medicare insurance product, and Southern or Western practice region also conferred a higher risk of blindness (OR > 1.28; P ≤ .01).
Conclusions
Blindness affects 1 of 9 patients with newly diagnosed PACG in the IRIS Registry. Black and Hispanic patients and Medicaid and Medicare recipients are at significantly higher risk. These findings highlight the severe ocular morbidity among patients with PACG and the need for improved disease awareness and detection methods.
MeSH Terms
Shields Classification
Key Concepts4
Among 43,901 eligible patients newly diagnosed with primary angle closure glaucoma (PACG) in the United States, the overall prevalence of any blindness (one or both eyes, visual acuity ≤20/200) was 11.5%, and bilateral blindness (both eyes, visual acuity ≤20/200) was 1.8% at first diagnosis.
Black patients with newly diagnosed primary angle closure glaucoma (PACG) were at a higher risk of any blindness (odds ratio [OR] 1.42; P < .001) and bilateral blindness (OR 2.04; P < .001) compared with non-Hispanic White patients, adjusted for ocular comorbidities.
Hispanic patients with newly diagnosed primary angle closure glaucoma (PACG) were at a higher risk of any blindness (odds ratio [OR] 1.21; P < .001) and bilateral blindness (OR 1.53; P < .001) compared with non-Hispanic White patients, adjusted for ocular comorbidities.
Among patients newly diagnosed with primary angle closure glaucoma (PACG), age <50 or >80 years, male sex, Medicaid or Medicare insurance product, and Southern or Western practice region conferred a higher risk of blindness (odds ratio [OR] > 1.28; P ≤ .01).
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